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NPI Code Detail

MEDICARE: JESSICA EARLY

MEDICARE:   JESSICA  EARLY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172A00000XDriver

General Provider Information

NPI Number : 1578391991
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA EARLY
Provider Business Mailing Address
First Line : 3777 CLAYTON DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70805-4202
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3777 CLAYTON DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70805-4202
Country : US
Telephone Number : 225-424-4160
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2024
Last Update Date : 07/25/2024

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Directions to “ JESSICA EARLY ” Practice Location

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